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8.21 ASSISTIVE TECHNOLOGY SERVICES
Introduction, Assistive Technology Services
CBVH provides assistive technology services through a network of Assistive Technology Centers and through private vendor High-Tech Consultants. All technology services are outcome-based and must be provided within the framework of the Assistive Technology Center Standards Manual.
Assistive Technology Centers
Eleven Assistive Technology Centers (ATC's) have been established by CBVH across the state. The centers, and the counties covered by each, are listed on p. 8.21.16. Referrals to ATC's should be based on the individual's county of residence, the location of the individual's work or education site, travel proximity, or availability of technology staff.
High-Tech consultants are persons with technical qualifications which allow them to meet many of the service needs addressed by the assistive technology centers. In this capacity, they may: conduct readiness evaluations, provide technical job coach development, provide on-site technical support, provide technical support for placement staff, conduct on-site evaluations, and perform on-site installations.
Whether employed directly by CBVH, or subcontracting with an Assistive Technology Center, consultants will be expected to use the same reporting format and perform to the same standards as the ATC's (see the ATC Standards Manual).
Rule, Use of High-Tech Consultants
Counselors may not authorize High-tech consultants to conduct consumer assessments or provide consumer training (services provided by ATC's under the ATC contract) without prior approval from the District Manager.
High-Tech Consultant Qualifications
All High-Tech consultants are expected to have a full range of hardware, software, and operating system skills and knowledge, as outlined in the ATC contract. In addition, the consultant must have verifiable skills in the requisite access modalities (braille, large print, speech) and assistive technologies specific to visual impairment.
Approval, High-Tech Consultants
If a consultant's services are being purchased directly by CBVH, the consultant must be approved as a private vendor (see Chapter 15.00, Private Vendors). Consultants applying for approval must complete the CBVH High-Tech Consultant Application Form found in Chapter 15.00.
Prior to submitting an application packet, each consultant must:
1. Receive a copy of the ATC standards and agree to provide any ATC services according to these standards, including required report forms.
2. Receive a copy of Microcomputer Software Training and Strategic Technical Intervention standards, and agree to provide services according to these standards.
High-Tech Consultant Travel
Travel expenses incurred by the consultant to meet with the counselor, consumer and/or staff at the job/education site to assess the site in which the equipment is to be used, will be reimbursed according to the guidelines found in Chapter 15.00, Private Vendors.
ATC Contracted Services
The following four services are provided on a contractual basis through the ATC's:
1. Consumer Assessment and Equipment Recommendation
2. Consumer Training
3. Training of CBVH Staff
4. ATC Staff proficiency.
Consumer Assessment and Equipment Recommendation, and Consumer Training are defined further in this chapter. For information on Training of CBVH Staff and ATC Staff Proficiency, refer to the ATC Contract and the ATC Standards Manual.
The following additional services may be authorized on a fee-for-service basis (from district office budgets) through ATC's or High-Tech Consultants serving as private vendors:
1. Readiness Evaluation
2. Technical Job coach Development
3. On-the Job Technical Support
4. Technical Support for Placement Staff
5. On-site Evaluation
6. On-site Installation
Rates for ATC's to provide this service are contained in the ATC contract. Rates to be paid to High-Tech consultants are contained in Chapter 15.00, Private Vendors.
If current information is not available from existing resources, counselors must arrange a readiness evaluation to determine the potential, or readiness, of the CBVH consumer to benefit from Assistive Technology services, and to recommend remediation of deficits identified. In making a referral for a readiness evaluation, counselors should use the Readiness Evaluation Referral and Report (ATC-01AEL, ATC Standards Manual).
The evaluation must include:
1. Typing evaluation
2. Reading comprehension
3. Spelling ability
4. Note-taking abilities.
Personnel Standard, Readiness Evaluation
In addition to ATC staff and High-Tech consultants, the readiness evaluation may be conducted by individuals who possess, at a minimum, a high school diploma and one year's experience working with individuals who are legally blind.
Duration, Readiness Evaluation
A readiness evaluation should not exceed six (6) hours, without counselor authorization.
Readiness Evaluation Report
The results of the Readiness Evaluation will be documented on the Readiness Evaluation Referral and Report (ATC-01AEL) which should be returned to the counselor within 10 working days of completion of the evaluation.
Counselor's Report, Readiness Evaluation
When making a determination of readiness based on available current information, counselors should document their findings on the Readiness Evaluation Referral and Report form (ATC-01AEL) and forward it with each referral for assistive technology assessment or training. The determination should not be based on the consumer's self-report, but on the counselor's observation, or formal testing from a school, evaluation site, or rehabilitation agency.
Determining Readiness from Evaluation Results
Readiness to participate in technology services may be indicated by the following levels:
1. Typing - 20 WPM
2. Reading comprehension - 8th Grade
3. Spelling - 8th Grade
4. Note-taking - sufficient to identify, organize and retrieve information
Preparing the Individual for Referral for Assistive Technology Services
Prior to making a referral for assistive technology services, the counselor must:
1. Discuss with the individual consumer his or her need for accommodations for academic/vocational training or placement purposes
2. Determine whether the individual has the basic skills necessary to participate in assessment or training
3. Inform the individual about what to expect from the service, providing the consumer with the "Assistive Technology Services - Information for Consumers" handout (ATC-08EL, ATC Standards Manual), and
4. Discuss with the consumer the equipment procurement process and ownership policies.
Information to Gather Prior to Referral
In order to determine the consumer's readiness for assistive technology services and provide adequate referral information to service providers, the counselor should obtain information about the consumer's:
1. Typing skills
2. Note-taking skills
3. Spelling skills
4. Reading level and ability
5. Travel skills
6. Daily Living skills
7. Work habits
8. Learning styles
9. Mode of accessing printed information
10. Familiarity, if any, with computers
11. Anticipated work or educational site
12. Special needs, if any
The first four skills areas above are typically covered through a Readiness Evaluation. Information about the other areas may be obtained from a variety of resources including the consumer, interviews with instructors or work supervisors, or training reports.
Initial Referral Information
After obtaining the above information, the counselor should prepare a referral packet which will include:
1. Completed CBVH Assistive Technology Referral (ATC-01BEL)
2. Most recent Confidential Health Assessment
3. Copy of the Readiness Evaluation Referral and Report (ATC-01AEL)
4. Most recent ophthalmology report, if available
5. Most recent low vision evaluation report, if applicable
6. Results of audiological exam, if applicable
7. Any reports of previous technology services
8. Appropriate authorization - OCFS-4226 for contracted services, DSS-335 for fee-based services
Low Vision Evaluations
Whenever possible, a low vision evaluation should include a test for ability and ease of reading a monitor screen.
An audiological evaluation should be obtained whenever the consumer has an apparent hearing loss and recent audiological information is not available.
Additional Packet Content
A referral packet may also include any of the following information, as applicable:
1. Job or educational task analysis and productivity requirements
2. Reports of other assessments: vocational assessment, communication skills evaluations, etc.
3. Copy of completed DSS-1013's indicating the equipment being purchased.
Once an initial referral has been made to an assistive technology provider, a subsequent referral to the same provider will consist of:
1. Assistive Technology Referral Sheet
2. Any other appropriate documentation not previously provided, and
3. OCFS-4226 or DSS-335
Referrals to Assistive Technology Centers
Counselors should be aware that the ATC contracts do not allow an ATC to reject a referral made for Consumer Assessment or any of the fee-based services.
Consumer Assessment and Equipment Recommendation
An assessment provides information about an individual's existing computer skills and knowledge, as well as the individual's ability to learn to use assistive technological devices. The information gathered is used by the counselor, ATC staff person, and individual to determine the next appropriate step in achieving the individual's vocational goal. Final recommendations on the assessment report will include: a recommendation for assistive equipment and a prediction of the likelihood that the individual will benefit from assistive technology training.
The duration of a consumer assessment will be no more than twelve hours. The assessment is expected to be completed within one calendar week, unless special arrangements are required due to restrictions placed on the consumer by his/her health or employer.
A comprehensive assessment report package will be forwarded to the referring counselor within 10 working days of completion of the assessment. See ATC-02EL, Final ATC Consumer Assessment Report (ATC Services Standards Manual)
Any recommendations for equipment will be reported on the Assistive Technology Center Equipment Recommendation, ATC-03EL (ATC Services Standards Manual).
Purchase of Recommended Equipment
CBVH will purchase equipment upon completion of an assessment and counselor approval of the recommendation.
CBVH retains the right to:
1. Make substitutions similar in function which may be more cost-effective than the original recommendation
2. Delete specific items
3. Delay purchase of any/all items, or
4. Choose not to purchase any of the equipment.
Final authorization will be agreed upon between the CBVH counselor and the CBVH Technology Coordinator. The CBVH counselor is responsible for informing the consumer and the assistive technology provider of any modifications to the original recommendation. (See section 8.22 for further information on assistive technology devices.)
Training familiarizes an individual with the assistive equipment configuration specifically recommended for him or her, from routine maintenance and care, to features, functions, system operation, and configuration assembly/disassembly. At the end of training, an individual will be expected to demonstrate, to the levels required in the ATC Standards Manual, proficiency in the function and use of the recommended assistive equipment configuration and software.
Individuals referred for Consumer Training must have completed a Consumer Assessment. However, exceptions can be made for training in the use of privately purchased equipment, with the agreement of the ATC.
Training in the use of the assistive equipment configuration will not commence until the equipment arrives, is tested, and is set up in good working order, or there is an equipment configuration available which matches the consumer specific configuration closely enough that the consumer can be trained with an acceptable transference of technical skills.
Limitations, Forms of Software
Training will be limited to a maximum of two forms of application software and one form of operating system software, but may be customized to fit the individual's needs within the time frame allowed. Additional training needs may be met through Strategic Technical Intervention or Microcomputer Software Training.
Advanced Software Training
As requested, the ATC training process may include advanced training in a limited set of functions, features, or commands of an application software package which is mandated by the consumer's job/education duties, and not covered under the basic training for that software. For example, a counselor could specify that training in the development of individual reports in DBASE is necessary.
This service option is NOT meant to address a comprehensive learning of all the advanced features the software has to offer. If more thorough advanced software training is needed, it must be acquired through Strategic Technical Intervention or Microcomputer Software Training.
Duration, Consumer Training
Consumer training will normally last for approximately 80 hours, with extensions up to 120 hrs. total as approved by the CBVH counselor. Consumers are expected to participate in training full time, unless there are restrictions placed on them by their employer or their health. In such instances, special arrangements may be made.
In situations in which an individual is unable to complete the training within the 120 hr. maximum, the counselor will meet with the consumer to determine the next appropriate steps to best meet the consumer's vocational needs.
A training report package will be submitted to the CBVH counselor within 10 working days of the completion of training. See ATC-04EL, Final ATC Consumer Training Report, ATC Services Standards Manual.
Shipment of Equipment Upon Completion of Training at a Center
After an individual has completed training at an Assistive Technology Center, the center will prepare and ship the consumer's equipment to his/her job/education site or home, or the CBVH office and will insure the shipment for the proper amount. The center may also agree to store the equipment at its facility.
The center will notify the referring counselor of the cost of shipment and insurance. The counselor will reimburse the facility for those expenses.
An on-site evaluation establishes a technical profile of the job/education site in which the individual will perform, and results in recommendations for assistive equipment to enable the consumer to meet the requirements of the job/education site. It is advisable to obtain an on-site evaluation whenever the job or education site is known and the individual may need technological accommodations to perform required tasks. An on-site evaluation must always occur before an on-site installation.
An On-site Evaluation should result in recommendations which encompass all ranges of technology, from none to simple to very sophisticated. The on-site evaluation report should also include a prediction of the likelihood of a successful installation of the equipment at the site, and identify a technical liaison.
Whenever possible, the CBVH counselor should be available at the site during the on -site evaluation.
Exception, On-site Evaluation
An on-site evaluation is not needed if the consumer only requires word-processing and note-taking capability in a portable medium, or only needs to communicate via a simple modem hook-up.
Duration, On-site Evaluation
An on-site evaluation should generally not exceed six (6) hours. Additional hours may be authorized at the counselor's discretion.
On-site Evaluation Report
The ATC On-Site Evaluation Report, ATC-05EL, should be submitted within 10 working days of completion of the service. Resultant equipment recommendations should be submitted on the ATC-03EL, ATC Equipment Recommendation Form.
Whenever possible, an on-site technical liaison should be identified. An on-site technical liaison is an individual situated or employed at the job/education site who is willing to learn about and take responsibility for the consumer's equipment configuration. The liaison provides on-site support to the CBVH consumer, and can provide valuable information about the need to interface with existing technological environments and equipment specifications which can be provided by the site. This individual may be a member of the technological support staff of the organization or may be a co-worker.
On-Site Technical Support
On-site technical support is designed to provide assistance at the job/education site to train technical liaisons on the specific assistive platform within the consumer's work/educational environment, and the level of on-going support necessary to enable the consumer to perform his/her specific tasks.
Duration, On-Site Technical Support
On-Site Technical Support should generally not exceed five hours. Additional hours may be authorized at the counselor's discretion.
On-site Equipment Installations
On-site installation is intended to insure that the consumer's specific assistive equipment is installed in the job/education setting in a manner in which the configuration interacts effectively in the environment, enabling the consumer to effectively perform the tasks required. It may include actual installation, assistance installing the configuration, and technical assistance provided over the phone.
At the completion of this service, the equipment configuration must function as designed for a consecutive two week period. This is verified with the on-site technical liaison (if established) and the individual using the configuration. This service is purely technical and equipment specific, and does not pertain to an individual's ability to use the equipment appropriately.
Expectations of Consumers, Stand-alone Equipment
On-site equipment installations are reserved for more complicated equipment set-ups. Consumers will be expected to be able to set up stand-alone equipment by themselves.
Exceptions may be made at the counselor's discretion.
Duration, On-site Installation
On-site installation should generally not exceed ten hours. Additional hours may be authorized at the counselor's discretion.
Equipment Installation Report
The Job/Education Site Equipment Installation report, ATC-06EL (ATC Services Standards Manual), must be submitted within one month of successful completion of the installation.
General Guidelines, High-Tech Equipment
General guidelines for the acquisition of high-tech equipment (including software) have been established as follows:
1 . Standard equipment configurations - CBVH will not purchase multiple configurations for use at multiple locations (unless justified by job or task requirements)
2. Equipment will only be upgraded when the original equipment is no longer appropriate for the intended tasks and the upgrade is necessary for continued functioning.
3. Computer access modes - a consumer will not be provided more than two modes of computer access (braille, large print or speech).
4. Color CCTV's - a color CCTV will only be provided to an individual where color is deemed necessary to the individual's job/education requirements.
5. Software - CBVH's responsibility is limited to the initial acquisition and installation of software. The counselor should document in the case record that the consumer understands that it is the consumer's responsibility to maintain and/or upgrade software if the employer is unwilling to do so.
A CCTV connected to a computer requires an assistive technology assessment; a stand-alone CCTV may be recommended by a low vision practitioner, rehabilitation teacher, or other qualified professional who is not an equipment vendor.
The counselor may decide to terminate assistive technology services for a consumer for a variety of reasons, including:
1. the consumer has become unavailable for service (due to illness, relocation, etc.)
2. the consumer failed to meet his/her responsibilities (e.g. poor attendance)
3. the consumer is not benefitting from the service, and is not expected to benefit from its continuation.
Withdrawal of Assistive Technology Referral
If the counselor has requested termination before services were initiated, the counselor should withdraw the authorization and make appropriate entries in the automated log.
Procedure, Service Termination
If the counselor decides to terminate services after services have been initiated, the counselor must:
1. Immediately notify the provider and request completion of the final service report. This should be completed by the provider within 10 days of receiving the request.
2. If the final service report is not received within 10 days of the request, the counselor should complete the final report form based on available information, noting "Objectives Not Met."
3. Arrange to have the final report information entered on the automated log.
Completion of Services
Upon receipt of the final assistive technology service report, the counselor has 30 days to decide to accept or reject the report.
Technical Support for Placement Staff
Recognizing that technology often plays a critical role in successful job development and placement, CBVH will authorize technical support to job placement specialists to assist them in understanding how assistive devices can enable ATC graduates to meet the demands of potential work environments.
Duration, Technical Support for Placement Staff
Technical support for placement staff is limited to ten hours, unless District Manager approval is obtained.
Technical Job Coach Development
Placement efforts can be further enhanced through the development of technical skills in job coaches. Upon referral from CBVH, a provider will train job coaches to provide them with specific skills in the application of assistive devices for the blind at job or educational sites. As the result of this training, job coach will have a working knowledge of the consumer's specific assistive equipment configuration and how it interfaces with the job/education site equipment. The job coach will also have the skills to assist the consumer in the use of the equipment and software in that setting.
Once a job coach is trained, CBVH will contract directly with job coach (if approved as a private vendor) or with the coach's employer.
Duration, Technical Job Coach Development
Technical job coach development should not be authorized for more than ten hours. Additional hours may be authorized at the discretion of the CBVH counselor.
Technical Job Coach Development Report
The final Technical Job Coach Development Report (ATC-13EL) should be submitted within 10 working days of the completion of the service.
Microcomputer Software Training
An ancillary service, microcomputer software instruction is provided to CBVH consumers who have successfully completed assessment and training at a CBVH approved Adaptive Technology Center or at another CBVH approved training source. This training is for the purpose of providing software specific instruction to individuals who require a thorough working knowledge of a particular software package for employment or educational purposes. It may be provided on an individual or group basis.
Consumers receiving this service should already be trained on their assistive equipment configuration, know how to use their computer, perform basic maintenance and assemble/disassemble their equipment. For further information on this service, see the Comprehensive Services contract.
Strategic Technical Intervention
Strategic technical intervention provides supplementary job/education site technical support services. Types of technical service covered include, but are not limited to:
1. New software installation
2. Highly specialized and computer specific job task training
3. Technical trouble-shooting
4. On-site consumer training.
Consumers receiving this service should already be trained on their assistive equipment configuration and know how to use their computer. For further information on this service, see the Comprehensive Services contract.
Duration , Strategic Technical Intervention
Strategic technical intervention is normally limited to 20 hours. Additional hours may be authorized at the discretion of the CBVH counselor.
Rehabilitation Engineering Services
While most rehabilitation technology needs can be met through CBVH Adaptive Technology Centers or approved high-tech consultants, it may be necessary at times to seek the assistance of a rehabilitation engineer skilled in adaptations needed for cognitive or physical impairments. Local VESID district offices can provide information on rehabilitation engineers they have used. Counselors may purchase rehabilitation engineering services from VESID approved vendors at the rate approved by VESID for this service.
Whenever possible, comparable benefits should be used.
Assistive Technology Centers and Counties Covered by Each
1. Center for Therapeutic Applications of Technology (SUNY Buffalo):
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
2. Association for the Blind and Visually Impaired of Greater Rochester - Goodwill: Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates
3. Aurora of Central New York, Inc.:
Broome, Cayuga, Cortland, Jefferson, Onondaga, Oswego, Tioga, Tompkins
4. Central Association for the Blind and Visually Impaired:
Chenango, Delaware, Fulton, Herkimer, Lewis, Madison, Montgomery, Oneida, Otsego, St. Lawrence
5. Northeastern Association of the Blind at Albany, Inc.:
Albany, Clinton, Columbia, Essex, Franklin, Greene, Hamilton, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
6. Lighthouse International (Westchester Lighthouse):
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester
7. Lighthouse International (New York Lighthouse Vision Rehabilitation Services):
Bronx, Brooklyn, Manhattan, Staten Island
8. Lighthouse International (Queens Lighthouse):
Nassau, Suffolk, Queens
9. Helen Keller Services for the Blind (Metropolitan NYC):
Bronx, Brooklyn, Manhattan, Staten Island
10. Helen Keller Services for the Blind (Long Island):
Nassau, Suffolk, Queens
11. Jewish Guild for the Blind:
Bronx, Brooklyn, Manhattan, Staten Island